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目的比较不同填塞物对鼻内镜鼻窦术后出血及粘连的影响,以寻求一种满意的填塞止血材料。方法分析76例鼻窦术后分别采用凡士林纱条33例(62侧),Merocel高膨胀止血材料17例(31侧),硅胶引流管(内径0.6cm,外径0.8cm)24例(46侧)3种材料填塞鼻腔,观察比较术后当天出血量、抽取填塞时出血量、术后粘连情况。结果①术后当天鼻腔渗血三组无统计学差别;②抽取填塞物时的出血量以凡士林纱条组占比例最高,其次为Merocel高膨胀止血材料,硅胶管组最少;③发生粘连情况,凡士林纱条组与Merocel高膨胀止血材料组分别为15%和17%,均高于硅胶管组。结论鼻窦手术尤其是引起中鼻甲漂移者用硅胶管加凡士林纱条固定填塞术腔能较长时间放置中鼻道,待中鼻甲固定成型后再取出,可有效防止中鼻甲外移粘连,由于放置时间较久抽取时一般不出血,不失为一种理想的鼻窦术后填塞材料。
Objective To compare the effect of different stuffing on hemorrhage and adhesion after endoscopic sinus surgery in order to find a satisfactory stuffing hemostatic material. Methods Totally 33 cases (62 sides) of vaseline gauze, 17 cases (31 sides) of Merocel high expansion hemostatic material, 24 cases (46 sides) with silicone drainage tube (0.6cm in diameter and 0.8cm in OD) Three kinds of materials stuffed the nasal cavity, observed and compared the amount of bleeding on the day after surgery, bleeding when pumping stuffing, and postoperative adhesions. Results ① There was no significant difference in nasal bleeding between the three groups on the day after surgery. ② The amount of bleeding during packing was highest in vaseline gauze group, followed by Merocel high expansion hemostatic material and silicone tube group at the least. ③ Adhesion, Vaseline gauze group and Merocel high expansion hemostatic material group were 15% and 17%, were higher than the silicone tube group. Conclusion Sinus surgery, in particular, caused by the drift of the middle turbinate with silicone tube plus Vaseline gauze packing chamber can be placed for a long time to be placed in the middle turbinate fixed shape and then removed, which can effectively prevent the migration of middle turbinate adhesions, as placed Extraction of time is generally not bleeding, after all, an ideal sinus surgery stuffing material.